Seizure management in dogs - here with an animal that is difficult to treat

This article is based on an article by Michaela Beasley, DVM, MS, MBA, CCRP, DACVIM (Neurology), Mississippi State University

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Medical history & signalling

Bully, a 5-year-old neutered male Labrador Retriever, was presented due to an increasing frequency of generalised seizures. Two years ago he was diagnosed with idiopathic/primary epilepsy - based on age at onset of first seizures (1-6 years), normal physical and behavioural characteristics, and a history of seizures. neurological examinations between seizures and inconspicuous metabolic laboratory values (e.g. complete blood count, clinical chemistry profile, bile acids, urine test).
The maximum recommended dose of extended-release levetiracetam (60 mg/kg orally every 12 hours) was administered.

Bully was often difficult to handle during vet visits, causing stress for him, his owner and the practice team. Several members of staff were required to restrain him during the examination; the owner was asked to put on a muzzle and a neck collar beforehand.

📌 What is „signalling“?

The Signalling is an integral part of the clinical description of an animal. It includes the basic Identification features, which can be important for the assessment, diagnosis and therapy of a patient - in other words, the „Profile“ of the animal.

You could also say that signalling is the first important building block in the assessment of an animal patient.

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🔍 What information is part of the signalling?

A complete signalisation usually includes

1. Animal species (e.g. dog, cat, rabbit, horse, etc.)
2. Race (e.g. Labrador Retriever, Maine Coon, European Shorthair)
3. Gender (male/female; intact or castrated/sterilised)
4. Age (e.g. 4 years, senior, puppy)
5. Weight (for dosages and assessment of nutritional status)
6. Coat colour & special characteristics (optional, e.g. black spots, tattoo, chip number)

👉 Example of a complete signalisation:

„Milo is a 7-year-old neutered male Border Collie with a body weight of 19 kg.“

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🧠 Why is the signalling important?

The signalling immediately provides important medical Indications of possible diseases, without symptoms already being mentioned. Because many Diseases are linked to age, gender or race together.

Here are a few examples:

• Age:
  • Young animals = more frequent infectious diseases, parasites, genetic diseases
  • Older animals = more frequent tumours, arthrosis, metabolic diseases
• Gender:
  • Female = hormonal diseases such as pyometra (uterine suppuration)
  • Male = prostate diseases, testicular tumours (in uncastrated males)
• Race:
  • French Bulldog = frequent breathing problems (brachycephaly)
  • Dobermann = genetic heart disease
  • Dachshund = tendency to herniated discs

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💬 Why is the signalling often mentioned at the beginning of case reports?

In medical reports, specialist articles or patient records, one often reads at the beginning:

„Luna, a 3-year-old spayed female, mixed breed, was presented due to...“

There is a good reason for this: the signalling contextualises the entire case. An epileptic seizure in a 6-month-old Chihuahua is medically assessed very differently to the same seizure in a 9-year-old German Shepherd.

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📎 Signalling vs. anamnesis - the difference

These two terms often appear together, but do not mean the same thing:

• Signalling = Who is the animal? (basic data, „profile“)
• Medical history = What has happened so far? (medical history, symptoms, course of disease)

Both together form the basis for any clinical judgement.

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The Signalling is the medical profile of an animal and contains all the basic data that is important for the correct categorisation of a disease or case. It helps vets, To narrow down diseases, to recognise typical problems and create more targeted treatment plans.

Sometimes it looks inconspicuous - but without signalling, the common thread in the veterinary assessment is missing. 🩺🐶🐱

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Clinical examination

The physical examination was largely unremarkable. Temperature, pulse and respiratory rate were normal. The heart and lungs were normal and no enlarged lymph nodes or abdominal organs were palpable. A limited neurological examination showed normal proprioception and retraction reflexes in all limbs, normal eyelid and pupil reflexes, normal threat response and normal muscles of mastication. The gag reflex could not be tested for safety reasons.

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Diagnostics

A repeat complete blood count, clinical chemistry profile and urinalysis were performed to rule out metabolic causes for the increased frequency of seizures. Alkaline phosphatase (ALP) was slightly elevated, otherwise there were no significant changes in red and white blood cells, platelets, electrolytes or liver and kidney values. The ALP elevation was attributed to hypoxia during a recent generalised seizure.
Levetiracetam serum levels were not determined as there are no established therapeutic target levels in dogs due to the high safety margin.

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Diagnosis

The diagnosis of idiopathic/primary epilepsy was retained, as no significant abnormalities were found in the physical or neurological examination or in the laboratory.

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Treatment & Management

Levetiracetam was a good first choice due to the low risk of side effects and the lack of need for drug level monitoring - especially for Bully, who was difficult to manage in the clinic. However, due to the increase in seizure frequency despite maximum dosage, additional medication was required.
With the owner Phenobarbital, Zonisamide and Potassium bromide discussed. In the end Zonisamide (5-10 mg/kg orally every 12 hours) as an additional anticonvulsant.

🧠 What does seizure management mean?

Seizure management includes all measures aimed at recognising and treating epileptic seizures in dogs (or other animals), reducing their frequency and maintaining or improving the affected animal's quality of life. It is therefore much more than „just giving a drug“ - it is a holistic, individually customised therapeutic approach.

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🔍 Aim of the seizure management

The main objective is not always complete freedom from seizures (even if this is desirable), but:

• Reduction in the frequency of seizures
• Shortening of the seizure duration and postictal phase (the time after the seizure)
• Minimisation of side effects of the medication
• Improving the quality of life - for animal and Owner

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⚠️ Why is this so important?

Repeated seizures can put a strain on the brain and cause long-term damage. Stress, anxiety, risk of injury or changes in behaviour (e.g. aggression or insecurity) can also be consequences of poorly controlled epilepsy.

This is why good management is so crucial - also in order to sudden death due to status epilepticus or Cluster seizures (both medical emergencies!).

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🧩 What does good seizure management consist of?

Several building blocks come into play here:

1. Diagnosis & seizure classification

• Differentiation between idiopathic epilepsy (without an identifiable cause) and symptomatic epilepsy (e.g. caused by tumours, inflammation, poisoning, etc.)
• Medical history: When did it start? How often? How long do the seizures last? What exactly happens?

2. Drug therapy

• Depending on the dog and the type of seizure, one or a combination of the following medications is selected:
  • Phenobarbital
  • Potassium bromide
  • Levetiracetam
  • Zonisamide
  • (possibly CBD or special diets)

3. Therapy control & monitoring

• Regular blood tests (especially liver, medication levels)
• Keep a diary of seizures (e.g. when, how severe, how long)
• Close communication with the vet

4. Customisation of the therapy

• Every dog reacts differently: dose adjustment, changes or combinations are often necessary
• Observe side effects (e.g. tiredness, feeding behaviour, liver damage)

5. Behaviour management

• Epilepsy can be accompanied by anxiety, insecurity or even aggression
• Medication such as Gabapentin, trazodone or clorazepate can help with fear of going to the vet
• A calm, stable environment reduces stress-related triggers for seizures

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💡 Additional management options

➕ Supplementary measures:

• Special diets with medium-chain triglycerides (MCT) can help
• CBD in consultation with the vet, as the study situation is still inconsistent
• Avoidance of triggers (stress, lack of sleep, overstimulation)

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🐶 And what about dogs that are difficult to treat („fractious“)?

Seizure management is particularly challenging for dogs that can hardly be examined or treated in the practice. Medication is the preferred choice here:

• Few side effects have,
• No frequent blood monitoring (e.g. levetiracetam),
• and as little stress as possible for dog and owner.

Sometimes a calming pre-treatment with medication can help to make blood tests or clinic visits possible at all.

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Good seizure management is a Customised timetable, who combines medical knowledge, experience and compassion.
It's not just about suppressing seizures - it's about giving the animal a safe, normal and anxiety-free life. ❤️🐕

If you like, I can also put together a guide to keeping a seizure diary or an overview of common medications with pros and cons. Just let me know!

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Let's take a deeper look together at the Treatment options for epilepsy in dogs throw. Drug therapy is a central component of seizure management, but each medication has its own special features, advantages and disadvantages. I will explain everything clearly so that you are well informed - regardless of whether you are a pet owner or work in veterinary medicine.

💊 Overview: Treatment goals

The aim of the treatment is Not always completely seizure-free, but:

• Seizures Less frequent, shorter and less severe make
• Minimise side effects
• The Improve quality of life
• The postictal phase (recovery phase after a seizure) shorten

Several medications are available for this - sometimes one is enough, in other cases a combination is needed.

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🧠 The most important medicines at a glance:

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1. Phenobarbital

🟣 One of the oldest and most commonly used antiepileptic drugs in dogs.

• Mode of action: Increases the threshold above which the brain triggers a seizure.
• Starting dose: 2.5-3 mg/kg orally every 12 hours
• Onset of action: After 1-2 weeks (steady state reached)
• Therapy mirror: Target: 15-35 µg/ml in the blood

🔍 Monitoring:

• Blood count, liver values and bile acids every 6 months
• Drug levels every 6-12 months or if side effects are suspected

⚠️ Side effects:

• Polyphagia (increased appetite)
• Polydipsia/polyuria (drinking/peeing a lot)
• Sedation, coordination problems
• Liver stress Possible with long-term use

👎 Caution with: Aggressive dogs - increased appetite can lead to food aggression.

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2. Potassium bromide (KBr)

🟡 Long half-life - ideal for owners who can only give once a day.

• Dose: 20-40 mg/kg orally every 24 hours
• Special feature: Extremely long half-life (approx. 3-4 weeks)
• Steady state: After about 3-4 months (can be shortened by so-called „loading dose“)

🔍 Monitoring:

• Blood levels every 6-12 months
• Control with every dose change

⚠️ Side effects:

• Sedation, ataxia (coordination disorders)
• Polyuria, polydipsia, polyphagia
• Hypertriglyceridaemia (high blood lipids, especially in combination with phenobarbital)
• Aggression possible - should therefore only be used with caution in dogs with behavioural problems

💡 Important: Keep the diet stable - chloride content in the feed influences bromide excretion.

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3. Levetiracetam

🟢 Very well tolerated - ideal for sensitive or difficult-to-handle patients.

• Dose:
  • IR (immediate release): 20-30 mg/kg every 8 hours
  • ER (sustained release): 30 mg/kg every 12 hours

💚 Advantages:

• Hardly any side effects
• No liver metabolisation → ideal for liver problems
• No regular blood level checks necessary

⚠️ Disadvantage: Must be administered relatively frequently (3× daily for IR form)
👀 Note: A higher dose is required if phenobarbital is administered at the same time.

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4. Zonisamide

🔵 Modern drug with sulphonamide structure - good additional option.

• Dose: 5-10 mg/kg orally every 12 hours
• Mould: Capsules (25, 50 or 100 mg)

💡 Advantages:

• Can be combined well with other antiepileptic drugs
• No influence on water intake or appetite

⚠️ Possible side effects:

• Keratoconjunctivitis sicca (dry eyes)
• Hepatotoxicity (liver stress)
• Vomiting, lethargy, lameness
• Tubular acidosis (rare)

🔍 Monitoring:

• Blood count, liver values, urine status before and approx. 2 weeks after commencement
• Thereafter every 6-12 months

👀 Note: Different manufacturers = different bioavailability - best to stick with one.

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🌿 Complementary & alternative therapy approaches

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✅ Medium-chain triglycerides (MCT) - dietary support

• Diets containing MCTs (e.g. „neuro support“ food) can improve seizure control
• Effect: Influences neurotransmitters in the brain (more inhibition, less excitation)
• Positive effects on behaviour and cognitive performance possible

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✅ Cannabidiol (CBD)

• dose (depending on the study): 2-4.5 mg/kg orally every 12 hours
• Effect on seizure control partially confirmed - but not yet conclusively proven
• Attention: The quality and dosage of the product vary greatly - only use tested preparations
• Side effect: ALP increase possible (liver value)

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🔁 Combination treatment

Sometimes medication alone is not enough. In such cases it is usual, to combine two or more antiepileptic drugs - e.g:

• Phenobarbital + potassium bromide
• Levetiracetam + zonisamide
• or other combinations

💡 Important: The risk of side effects increases with combination therapies → regular checks are essential!

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🐾 Which therapy is the right one?

That depends on:

• The Type and frequency of the seizures
• Age, breed and state of health of the dog
• Already existing organic diseases (e.g. liver, kidney)
• Behaviour of the dog (e.g. fear, aggression, stress in the clinic)
• And very importantly: Living conditions and possibilities of the owners

Good seizure management is always individualised!

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The treatment options for epilepsy in dogs are varied - and no one medication is equally suitable for everyone. Careful selection, regular monitoring and close co-operation between vet and owner are the key to success.

If you like, I can create a table or overview for you to print out - with dosages, benefits and possible side effects of the individual medications. Just let me know! 😊

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Course

One week after the start of zonisamide therapy, the liver values were checked. There were no significant changes, so the treatment was continued. Two weeks after the start of therapy (after reaching steady state), the owner reported by telephone that Bully had not had any seizures in the last 12 days.

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Discussion

Timing of treatment & choice of medication

Antiepileptic medication is recommended if:

• ≥2 seizures occur within 6 months,
• Status epilepticus or serial seizures are present,
• the postictal phase is prolonged or severe,
• or seizure frequency or severity increases.²

If the initial therapy is not successful and control is achieved with an additional medication, the first medication can be slowly phased out - but only after consultation with the owner about the risk of new seizures.

When selecting a medication, concomitant illnesses, existing medication and the owner's circumstances should be taken into account (e.g. frequency of administration, financial means, side effect tolerance).² Certain medications require monitoring of drug levels and blood values.

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Treatment options

Phenobarbital

• Dose: 2.5-3 mg/kg orally every 12 hours
• Therapy mirror: 15-35 µg/mL (after 10-14 days)
• Monitoring: CBC, liver values, bile acids every 6 months
• Side effects: Polyuria, polydipsia, polyphagia, possible drug interactions
• Caution with: Aggressive dogs - polyphagia can promote food aggression

Potassium bromide

• Dose: 20-40 mg/kg orally every 24 hours
• Steady state: 4 months (without saturation)
• serum levels: 1000-3000 mg/L
• Side effects: Polyuria, polydipsia, polyphagia, hypertriglyceridaemia (especially with phenobarbital), aggression possible
• Note: Do not change diet (Cl intake influences excretion)

Levetiracetam

• Dose: 20-30 mg/kg every 8 hours (IR), 30 mg/kg every 12 hours (ER)
• Effect: Few side effects, no liver metabolisation
• Monitoring: Drug levels are not routinely determined
• Note: Good option for difficult patients

Zonisamide

• Dose: 5-10 mg/kg orally every 12 hours
• Side effects: KCS, vomiting, lameness, hepatotoxicity, tubular acidosis
• Monitoring: Blood values before and 1-2 weeks after starting therapy, then every 6-12 months
• Note: No influence on drinking/eating behaviour

Medium-chain triglycerides (MCT)

• Supplementation of 9 % of the energy requirement can be achieved via certain diets
• Improvement of cognitive function, behaviour and seizure control possible

Cannabidiol (CBD)

• Dose: 2-4.5 mg/kg orally every 12 hours (depending on the study)
• Effect: Possible reduction in the frequency of seizures, but inconsistent study situation
• Side effect: Increase in ALP

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Treatment at a glance

• Usual medication: Phenobarbital, Potassium bromide, Levetiracetam, Zonisamide
• Polyuria, polydipsia, polyphagia with phenobarbital and potassium bromide
• Liver enzymes may be elevated with phenobarbital, zonisamide, CBD
• Drug level monitoring recommended for phenobarbital and potassium bromide

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Dealing with patients who are difficult to treat

Dogs with idiopathic epilepsy have an increased risk of behavioural changes such as anxiety, aggression or hyperreactivity.
Potassium bromide should only be chosen as a last resort for aggressive dogs. Drugs with a risk of polyphagia (e.g. phenobarbital) can promote food aggression.

For patients who are difficult to manage, drugs that require as little monitoring as possible should be favoured - e.g. levetiracetam.

To reduce stress during clinic visits:

• Gabapentin: 10-50 mg/kg the evening before and 2 hours before the appointment
• Clorazepate: 0.5-2 mg/kg (optional)
• Trazodone: 5 mg/kg 1-2 hours before the appointment (caution with simultaneous administration of anticonvulsants)
• If necessary: IM/IV Sedation with dexmedetomidine (5-10 µg/kg) ± butorphanol (0.2-0.4 mg/kg)

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Forecast & result

Dogs with idiopathic epilepsy can have a normal life expectancy and good quality of life with good seizure control and minimal side effects.
If the quality of life is perceived as poor by the owner (e.g. due to aggression), this can lead to earlier euthanasia.
There is a certain risk of status epilepticus, serial seizures or sudden death - especially in brachycephalic breeds or frequent serial seizures.

Aim of the therapy: Minimisation of seizures and postictal phase without side effects.

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Key findings

• Gabapentin (high dose) with/without clorazepate can facilitate handling
• Dexmedetomidine + butorphanol for sedation, if necessary
• Potassium bromide Can cause aggression → last option for aggressive dogs
• Epileptic dogs may develop behavioural changes due to the disease or medication

Frequently asked questions about seizure management in dogs

Summary: Seizure management in dogs

The Seizure management in dogs is a central topic in small animal neurology and affects many pet owners, as epilepsy is one of the most common neurological diseases in dogs. A systematic, individualised and holistic Seizure management in dogs can make a decisive contribution to the quality of life of the affected animal and its human.

Seizure management in dogs begins with a detailed medical history. In addition to the description of the seizures, information on age, race, state of health and environment is crucial in order to develop a customised concept for the patient. Seizure management in dogs to create.

An important component in the Seizure management in dogs is the distinction between isolated seizures and actual epilepsy. While an isolated seizure can have many causes, such as intoxication or metabolic disorders, at least two unprovoked seizures are referred to as epilepsy - which requires a structured Seizure management in dogs required.

The diagnosis of „idiopathic epilepsy“ - i.e. epilepsy with no recognisable cause - is a diagnosis of exclusion and influences the strategy for the treatment of epilepsy. Seizure management in dogs considerable. Modern diagnostics (e.g. blood tests, MRI, cerebrospinal fluid analysis) support a well-founded therapy decision within the framework of the Seizure management in dogs.

In therapy, the aim of the Seizure management in dogs not necessarily complete freedom from seizures, but a reduction in the frequency, severity and duration of seizures while at the same time minimising side effects.

These include medications such as Phenobarbital, Potassium bromide, Levetiracetam or Zonisamide, which are used individually or combined depending on the case. The choice of medication depends on the Seizure management in dogs depends on many factors, including age, liver function, behaviour, life situation and tolerance.

Important in Seizure management in dogs is also monitoring. Depending on the medication used, blood values and drug levels are checked regularly. This allows side effects to be recognised at an early stage - an essential part of safe treatment. Seizure management in dogs.

In addition to drug treatment, diet and lifestyle are also important pillars in the Seizure management in dogs. Studies show that special diets containing medium-chain triglycerides (MCTs) can have a positive effect on seizures. A stable environment, avoidance of stress and regular daily routines contribute to the success of the Seizure management in dogs with.

For dogs that do not respond well to treatment in the practice, a low-stress environment is recommended. Seizure management in dogs important. Medications such as levetiracetam, which does not require frequent monitoring, are well suited. In addition, anxiolytic drugs such as gabapentin or trazodone help to make examinations less stressful - this is also part of the modern Seizure management in dogs.

A valuable instrument in the Seizure management in dogs is that Seizure diary. It helps to recognise changes and evaluate the effectiveness of the therapy. The documentation of the time, duration, triggers and behaviour during and after the seizure is an indispensable tool in the Seizure management in dogs.

Alternative or complementary therapies such as Cannabidiol (CBD) or behavioural therapy can Seizure management in dogs always under veterinary supervision and with evidence-based assessment.

Behavioural changes, such as anxiety or aggression, can occur as a result of both the underlying illness and the medication. A sensitive, holistic Seizure management in dogs therefore takes into account not only the neurological but also the emotional needs of the animal.

A good Seizure management in dogs means teamwork between vet, owner and, if necessary, veterinary practitioner or behavioural therapist. Only through open communication, regular check-ups and a feeling for the animal can a stable and healthy behaviour be achieved in the long term. Seizure management in dogs.

A modern Seizure management in dogs is dynamic - treatment plans need to be regularly reviewed and adapted. If a medication no longer works or new symptoms occur, quick action is required.

The prognosis for idiopathic epilepsy is good in many cases, when seizure management in dogs is carried out consistently, individually and with a sense of proportion. Many affected dogs live with a good quality of life and a normal everyday life.

To the Seizure management in dogs also includes education about emergency situations. Pet owners should know how to react in the event of a seizure, what is dangerous (e.g. seizures lasting >5 minutes) and when an immediate visit to the vet is necessary.

In particularly serious cases, a Combined seizure management for dogs with several anticonvulsants may be necessary. Close monitoring is particularly important here in order to control side effects and interactions.

Ultimately, this means Seizure management in dogs It is always important to see the dog as a whole - physically, mentally and emotionally. This is the only way to achieve a long-term quality of life that satisfies both animals and humans.

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🏁 Conclusion:

Seizure management in dogs is a complex but controllable field of veterinary medicine. With knowledge, patience, cooperation and an individualised approach, veterinarians caninside and ownersachieve a lot together. Through a well thought-out, regular and customised Seizure management in dogs can not only control the disease - but also give the animal a good, safe and happy life

Sources:

1. De Risio L, Bhatti S, Muñana K, et al. International veterinary epilepsy task force consensus proposal: diagnostic approach to epilepsy in dogs. BMC Vet Res. 2015;11:148. doi:10.1186/s12917-015-0462-1
2. Bhatti SFM, De Risio L, Muñana K, et al. International veterinary epilepsy task force consensus proposal: medical treatment of canine epilepsy in Europe. BMC Vet Res. 2015;11:176. doi:10.1186/s12917-015-0464-z
3. Phenobarbital. VIN Veterinary Drug Handbook, 2023. Veterinary Information Network. Accessed November 29, 2023. https://www.vin.com/members/cms/project/defaultadv1.aspx?pId=13468&id=7397935&sx=241879528&n=1&f5=1
4. Rossmeisl JH, Inzana KD. Clinical signs, risk factors, and outcomes associated with bromide toxicosis (bromism) in dogs with idiopathic epilepsy.J Am Vet Med Assoc.2009;234(11):1425-1431. doi:10.2460/javma.234.11.1425
5. Bromides. VIN Veterinary Drug Handbook, 2023. Veterinary Information Network. Accessed November 29, 2023. https://www.vin.com/members/cms/project/defaultadv1.aspx?pId=13468&id=7308442&sx=241879701&n=1&f5=1
6. Levetiracetam. VIN Veterinary Drug Handbook, 2023. Veterinary Information Network. Accessed November 29, 2023. https://www.vin.com/members/cms/project/defaultadv1.aspx?pId=13468&id=7313542&sx=241881822&n=1&f5=1
7. Zonisamide. VIN Veterinary Drug Handbook, 2023. Veterinary Information Network. Accessed November 29, 2023. https://www.vin.com/members/cms/project/defaultadv1.aspx?pId=13468&id=7310512&sx=241882198&n=1&f5=1
8. Berk BA, Ottka C, Law TH, et al. Metabolic fingerprinting of dogs with idiopathic epilepsy receiving a ketogenic medium-chain triglyceride (MCT) oil. Front Vet Sci. 2022;9:935430. doi:10.3389/fvets.2022.935430
9. Garcia GA, Kube S, Carrera-Justiz S, Tittle D, Wakshlag JJ. Safety and efficacy of cannabidiol-cannabidiolic acid rich hemp extract in the treatment of refractory epileptic seizures in dogs. Front Vet Sci. 2022;9:939966. doi:10.3389/fvets.2022.939966
10. Rozental AJ, Weisbeck BG, Corsato Alvarenga I, et al. The efficacy and safety of cannabidiol as adjunct treatment for drug-resistant idiopathic epilepsy in 51 dogs: a double-blinded crossover study.J Vet Intern Med. 2023;37(6):2291-2300. doi:10.1111/jvim.16912
11. Potschka H, Fischer A, Löscher W, et al. International veterinary epilepsy task force consensus proposal: outcome of therapeutic interventions in canine and feline epilepsy. BMC Vet Res. 2015;11:177. doi:10.1186/s12917-015-0465-y
12. Trazodone. VIN Veterinary Drug Handbook, 2023. Veterinary Information Network. Accessed November 29, 2023. https://www.vin.com/members/cms/project/defaultadv1.aspx?pId=13468&id=7418282&sx=241891142&n=1&f5=1
13. Ballantyne KC. Fear free psychopharmacology: selecting appropriate pre-visit pharmaceuticals & sedation protocols for dogs & cats. Presented at: Western Veterinary Conference; February 16-19, 2020; Las Vegas, NV.
14. Watson F, Packer RMA, Rusbridge C, Volk HA. Behavioural changes in dogs with idiopathic epilepsy.Vet Rec. 2020;186(3):93. doi:10.1136/vr.105222

Suggested literature

• Thomas WB, Dewey CW. Seizures and narcolepsy. In: Dewey CW, da Costa RC, eds. A Practical Guide to Canine and Feline Neurology. 3rd ed. Wiley-Blackwell; 2016:249-268.